Nitric oxide as a marker for evaluation of treatment effect of cyclosporine A in patients with bladder pain syndrome/interstitial cystitis type 3C

Abstract

The results indicate that measurement of NO is a tool for evaluating the response to anti-inflammatory treatment in patients with BPS/IC type 3C. NO could serve as a marker for assessing the activity of the inflammation.

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

“…[95][96][97][98] Patients with Hunner's lesions seem to derive a better response than those without Hunner's lesions (68% vs. 30%, respectively). 96 A single RCT comparing CyA to PPS showed a significant improvement in IC/BPS symptoms with CyA treatment compared to PPS (59% vs. 13%, p<0.001).…”

Treatment effect of cyclosporine A in patients with painful bladder syndrome/interstitial cystitis: A systematic review

“…Six studies used the NIDDK criteria for diagnosing IC (12,14,(16)(17)(18); the other two studies used clinical symptoms to diagnose PBS/IC (11,13). The subjects of two studies (13,14) were patients in whom multiple first line therapies had failed.…”

“…Eight articles (11)(12)(13)(14)(15)(16)(17)(18) were finally included as eligible articles, which including a total of 298 subjects with a median number of 37.25 subjects per study. These 8 studies included 3 RCTs (16)(17)(18), 4 prospective cohort studies (11)(12)(13)15) and 1 retrospective cohort study (14). In the 7 studies that reported the ages of the subjects, the age predilection was 40-70 years.…”

“…The O'Leary-Sant Symptom and Problem Indices of Interstitial Cystitis (ICSI and ICPI, respectively) were used as outcome measures in 5 studies (11)(12)(13)16,17). Other outcome parameters were reported, including mean voided volume (ml) (12,(14)(15)(16)(17), maximum awake bladder capacity (ml) (14)(15)(16), urinary frequency (24 h) (14)(15)(16)(17), pain score (visual analog scale, VAS) (16,17), cytokine levels (11,17), daily urinary output (ml) (15), nocturia episodes (16) and improvement of quality of life (QoL) (18). All outcome parameters, with the exception of the biomarker IL-6, were reported to exhibit improvement following treatment of CyA, even though the degree of improvement varied.…”

“…To the best of our knowledge, he present review summarizes all the prospective or retrospective non-randomized cohort trials and RCTs that exist on this topic. CyA may be more advantageous in severe PBS/IC, because two studies (11,13) included patients in whom the usual IC/BPS treatments had failed, and the symptoms and parameters in those patients improved following treatment with CyA (2-3 mg/kg divided into 2 daily dosages with a maximum of 300 mg daily). In addition CyA exhibited a higher curative effect than PPS.…”